title: Primary induction with mycophenolate mofetil and corticosteroids in a liver transplant recipient with hepatorenal syndrome.
abstract: OBJECTIVE
  To report the use of mycophenolate mofetil for primary induction in a liver transplant recipient to avoid the nephrotoxicity of cyclosporine/tacrolimus.
  
  
  METHODS
  A 47-year-old white man in a hepatic coma with anuric hepatorenal syndrome received a liver transplant, and was given mycophenolate mofetil and corticosteroids as primary induction immunosuppression with the addition of low-dose cyclosporine 13 days later. His renal function improved and he remains rejection-free after 13 months of follow-up.
  
  
  CONCLUSIONS
  This case suggests that mycophenolate mofetil may be used as a primary induction agent in liver transplant recipients with renal failure to avoid the additional nephrotoxicity of the standard immunosuppressants, cyclosporine and tacrolimus. Low-dose cyclosporine/tacrolimus may be introduced later as the renal function improves.
authors.affiliation: Vancouver Hospital and Health Sciences Centre, British Columbia, Canada.
authors.forename: R R
authors.initials: RR
authors.lastname: Carr
authors.forename: E M
authors.initials: EM
authors.lastname: Yoshida
authors.forename: S W
authors.initials: SW
authors.lastname: Chung
authors.forename: N
authors.initials: N
authors.lastname: Partovi
mesh_terms: D006501:Hepatic Encephalopathy / Q000209:etiology; D006530:Hepatorenal Syndrome / Q000150:complications / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid